Why Does a No Excuses Health Policy Lead to No Results in Brazil?

Brazilian poverty is a familiar subject to many of us. Images of the favelas or massive slums surrounding Brazil’s major cities have reached us one way or the other, whether through movies, newspapers or some other route. According to the World Development Indicators, the top 10% of Brazilians hold 43% of the income, while the bottom 10% only hold 1%. Poverty alleviation strategies have long been a focus in Brazilian policymaking, and with good reason. In 2003, newly-elected president Lula da Silva announced a new program of social policy, called Fome Zero or Bolsa Familia. This program would combine 13 government agencies in a national fight against both the symptoms of poverty as well as its roots. Bolsa Familia would eliminate the redundancies and gaps of previous social policy, and work to make all programs reinforce each other, regardless of what aspect of poverty each program targeted. The crown jewel of the program were conditional cash transfers for the poor, which could be spent on anything but were only given to those families fulfilling certain conditions relating to child health and education, among other objectives. Money lost by allowing children to attend school and make visits to the doctor rather than work would be made up by the transfer received for fulfilling the conditions. This eliminates one of the main reasons that the poor avoid this sort of social...

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